It's Not Enough For Trump To Declare Opioid Epidemic A National Emergency

President Donald Trump has called the opioid crisis a national emergency. (Photo: NICHOLAS KAMM/AFP/Getty Images)

Yes, the first step to recovery from any problem is admitting that you have a problem. Thursday, while at his golf club in Bedminster, N.J., President Donald Trump told reporters, “The opioid crisis is an emergency, and I’m saying officially right now it is an emergency. It’s a national emergency. We’re going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis.”

That evening, the White House followed up with a statement that Trump “has instructed his Administration to use all appropriate emergency and other authorities to respond to the crisis caused by the opioid epidemic.” So, now "toot, toot," we're all set, and the train is in motion to solve the opioid crisis -- right? Not really.

Here's what declaring the crisis a national emergency could do, with the emphasis on the word could. First, it's symbolic and could raises awareness of the problem. It also could make it easier to mobilize certain types of resources and funds to tackle the crisis. As German Lopez described for Vox, the Trump administration has two avenues through which to declare a national emergency. The Stafford Act via a declaration from the President could make available those resources (e.g., the federal disaster relief fund) that are usually used for natural disasters such as Hurricane Katrina while the Public Health Service Act via a declaration from the Secretary of Health and Human services could make available those resources that are usually used for a more rapidly emerging disease threat, such as the 2009 influenza pandemic. Again, could, could, could...

Grant waiver approvals for all 50 states to quickly eliminate barriers to treatment resulting from the federal Institutes for Mental Diseases (IMD) exclusion within the Medicaid program.

Mandate prescriber education initiatives with the assistance of medical and dental schools across the country to enhance prevention efforts.

Immediately establish and fund a federal incentive to enhance access to Medication-Assisted Treatment (MAT). Require that all modes of MAT are offered at every licensed MAT facility and that those decisions are based on what is best for the patient. Partner with the National Institutes of Health (NIH) and the industry to facilitate testing and development of new MAT treatments.

Provide model legislation for states to allow naloxone dispensing via standing orders, as well as requiring the prescribing of naloxone with high-risk opioid prescriptions.

Prioritize funding and manpower to the Department of Homeland Security’s (DHS) Customs and Border Protection, the DOJ Federal Bureau of Investigation (FBI), and the Drug Enforcement Agency (DEA) to quickly develop fentanyl detection sensors and disseminate them to federal, state, local, and tribal law enforcement agencies. Support federal legislation to staunch the flow of deadly synthetic opioids through the U.S. Postal Service (USPS).

Better align, through regulation, patient privacy laws specific to addiction with the Health Insurance Portability and Accountability Act (HIPAA) to ensure that information about SUDs be made available to medical professionals treating and prescribing medication to a patient. This could be done through the bipartisan Overdose Prevention and Patient Safety Act/Jessie’s Law.

These recommendations could be helpful starts but don't go far enough towards solving the real problems behind the crisis. (To be fair, the Commission's full report won't come out until this Fall, so more recommendations may eventually emerge.) Other groups have already gone further in their recommendations such as the Substance Use Disorder Treatment Task Force convened by Shatterproof, an organization founded by Gary Mendell to help tackle the opioid crisis. In general, Mendell has pushed for more science-based approaches to addressing the crisis and Shatterproof's Task Force includes a wider range of scientific and healthcare experience and expertise. Also, today, as part of the U.S. Conference of Mayors' Summer Leadership meeting in New Orleans, Mayors from both sides of the political aisle called on Governor Christie’s opioid commission to include Republican and Democratic mayors, who have a much better perspective on what is happening at the local level. Not including Mayors and more scientists and healthcare experts on Christie's Commission is like trying to win the Super Bowl without consulting the players and coaches...or drive a train without checking with the engineers, wheels, or the engine.

US Conference of Mayors President, New Orleans Mayor Mitch Landrieu, along with over 50 of the nation’s leading mayors convening today in New Orleans, called on Governor Christie’s opioid commission to include Republican and Democratic mayors....

Another problem is that other actions taken by the Trump Administration may derail any hope for a true solution. For example, where will the resources, knowledge, and strategies come from if the White House proceeds with its proposed massive budget cuts to scientific (e.g., the National Institutes of Health) and public health (Centers for Disease Control and Prevention) funding? Does dissolving the one federal agency that focuses on quality of healthcare, the Agency for Healthcare Research and Quality (AHRQ), make any sense in light of the opioid crisis being fueled in part by medical care issues and the solution will require changes in health care operations? Moreover, how will any healthcare reform plan, such as those so far proposed in Congress, that leaves more people uninsured and further cuts public health funds not hinder efforts to fight the opioid crisis? The answers are "who knows", "nope", and "I dunno."